Diabetes mellitus type 1 - Is sometimes called juvenile diabetes because it develops in children, adolescents and young adults. This condition occurs when metabolism is disordered and blood sugar is too high.

Blood sugar, or glucose in the blood comes from the food and drink a person consumes. In a healthy body, the pancreas produces insulin, a hormone needed to change glucose into energy. The pancreas maintains a balance between food intake and insulin. When a person eats, the pancreas provides the correct amount of insulin needed to turn the glucose into energy. The pancreas in a person with type 1 diabetes doesn't produce any insulin. Without insulin, glucose in the blood builds up, causing hyperglycemia, or high blood sugar. Blood sugar levels that are too high and untreated for long periods of time can eventually lead to coma and death.

Controlling type 1 diabetes with insulin

Since people with type 1 diabetes can't produce their own insulin, they must use injections or an insulin pump to put insulin into their blood stream. People with type 1 diabetes have to determine how much insulin to inject. There is no sure way to do this with 100% accuracy because many factors influence how much insulin is needed. Different foods have different absorption rates.

Other factors include the effects of illness, exercise and stress. As children grow, their insulin needs also change. If they inject too much insulin (or eat too little) they may have a low blood sugar reaction. Hypoglycemia (low blood sugar) is the most common problem in children with diabetes. This can be very serious and requires immediate attention.

Risk of Complications

Over a number of years, continued high blood sugar levels can cause serious damage to the body's organ systems. This can affect the heart, nerves, kidneys, eyes, and other parts of the body. A number of studies have proven that careful monitoring and control of blood sugar levels greatly reduces the threat of these complications.

An estimated 17 million people in the U.S. have diabetes, of which between 5-10 percent or about 1.4 million have type 1 diabetes. The risk of developing type 1 diabetes is higher than virtually all other severe chronic diseases of childhood. Type1diabetes tends to run in families. Brothers and sisters of a child with type1 diabetes have 100 times the risk of developing the disease than does a child in an unaffected family.

Presently there is no cure; however researchers are making progress in developing new treatments and technologies to help people with diabetes stay healthy. In the meantime, people with diabetes must do their best to control it with diet, exercise, and insulin.

The exact cause of type 1 diabetes is still unclear. However, it is believed that Type 1 diabetes results from an infectious or toxic insult to persons whose immune system is genetically predisposed to develop an aggressive autoimmune response either against altered pancreatic B antigens (proteins) or against molecules of the B cell resembling a viral protein (called molecular mimicry). It is not caused by obesity or by eating excessive sugar.

Type 2 diabetes is also known as insulin-resistant diabetes, non-insulin dependent diabetes, and adult-onset diabetes – the latter because it is commonly diagnosed in people over the age of 45, though it is often found in people much younger.

In type 2 diabetes the beta cells of the pancreas produce insulin but the body is unable to use it effectively because the cells of the body are resistant to the action of insulin. Although this type of diabetes may not carry the same risk of death from ketoacidosis, it otherwise involves many of the same risks of complications as does type 1 diabetes.

Treatment is to normalize the blood glucose in an attempt to prevent or minimize complications. People with type 2 diabetes may experience marked hyperglycemia, but most do not require insulin injections. In fact, 80% of all people with type 2 diabetes can be treated with diet, exercise, and, if need be, oral hypoglycemic agents (drugs taken by mouth to lower the blood sugar).

Type 2 diabetes requires good dietary control including the restriction of calories, lowered consumption of simple carbohydrates and fat with increased consumption of complex carbohydrates and fiber. Regular aerobic exercise is also an important method for treating type 2 diabetes since it decreases insulin resistance and helps burn excessive glucose. Regular exercise also may help lower blood lipids and reduce some effects of stress, both important factors in treating diabetes and preventing complications.

An Epidemic of Type2 Diabetes

In recent years, numbers of people of all ages, in the USA and in other developed nations, diagnosed with type 2 diabetes has dramatically increased. Rising diabetes rates in this nation and around the world are alarming health officials. The World Health Organization estimates that 171 million people were living with diabetes in 2000, and that 266 million will have it in 2030.

Pregnant women who have never had diabetes before but who have high glucose levels during pregnancy are said to have gestational diabetes.

Gestational diabetes affects about 4% of all pregnant women - about 135,000 cases of gestational diabetes in the United States each year and frequently progresses to type 2.

Pre-diabetes is a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes.

There are 57 million Americans who have pre-diabetes, in addition to the 23.6 million with diabetes.